The struggle for environmental and social justice within American Indian communities is one that has been ongoing since the beginning of United States history, but the main catalyst to effect change and to promote and disperse the American Indian narrative has emerged through the power of social media in today's hyperconnected society. This article examines the power of social media to effect change, as well as a hyperconnected society's ability to empower historically disadvantaged groups that have often been misrepresented within traditional media outlets. The historic movement occurring at Standing Rock, North Dakota, and the #NoDAPL protests illustrates the capacity of social media to galvanize individuals to become changemakers as well as create a vast support network within a population that might otherwise remain uninformed or unaware of media misrepresentations. The role of libraries as support systems within communities and the responsibility of libraries to provide unbiased and freely available information within a hyperconnected society are also discussed.

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While the state of government information librarianship continues to evolve alongside the libraries in which those librarians work, there remains a consistent lack of full integration of government information into the instruction landscape. The reasons for this have been covered within the literature as well as suggestions on how to overcome those barriers. Even with this literature, a gap in implementation remains. This article highlights the collaborative partnership between a government information librarian and student success librarian that attempts to bridge the gap between scholarship and practice in the hopes of creating a more robust government information presence in the academic instruction landscape at their university both in the classroom and beyond.

Objective To describe our technique and review our experience with synchronous robotic bilateral nephrectomy for large kidneys in ADPKD with the Da Vinci XI and Da Vinci Single Port platforms (Intuitive Surgical, Sunnyvale, CA). Materials and Methods We performed a retrospective review of all robotic bilateral nephrectomy cases from January 2020 to October 2021 at a high-volume robotic single center. Demographic data and perioperative details including preoperative CT scans, indication for nephrectomy, and renal function were collected. We also collected post-op course data and final specimen data details. Results Eleven cases were included. Patient demographics, indications for surgery, and specimen data are outlined in table 1. The largest kidney removed measured 32 cm in largest dimension on preoperative imaging. Median operating time from incision to closure was 299 minutes (IQR 260, 339). Median estimated blood loss was 100cc (IQR 50, 175). Two patients were transfused intraoperatively. Median pre- and post-operative Hgb was 11.3 and 9.7 respectively. Median length of stay was 3 days (IQR 2, 3.5). There were no intraoperative complications and no open conversions. Post-operative complications included one incisional hematoma, and one superficial wound infection. One patient was admitted to the surgical ICU post operatively for ventilatory support. Two patients were readmitted within 30 days of surgery. Conclusion The robotic approach to bilateral native nephrectomy for ADPKD should be considered when native nephrectomies are indicated. The operative times and outcomes compare favorably to prior series and this technique works even for very large kidneys.

anatomical reconstructed images, all patients were cleared to undergo donor nephrectomy based on the additional information that was provided from the virtual models. In the patient with the perihilar mass, the 3D imaging delineated the mass as arising from the renal parenchyma. This patient underwent robotic donor nephrectomy with ex-vivo excision of the mass (pathology: lipid-poor renal angiomyolipoma), with successful subsequent renal transplantation. All 63 patients underwent uneventful laparoscopic or robotic donor nephrectomy.CONCLUSIONS: Virtual 3D anatomical modeling with IRISä allows surgeons to perform donor nephrectomy in patients that may otherwise be excluded from renal donation. This technology offers preoperative interpretation of renal anatomy, provides confidence in the setting of complex vasculature, and facilitates planned procedural completion.